Pittsburgh guides helping people through Obamacare maze

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Titus North, executive director of Citizen Power, a research and advocacy group in Squirrel Hill, has taken on an additional role in the past few weeks: helping people sign up for health care policies on the federal insurance exchange created by the Affordable Care Act.

Last week, he said, he spent about three hours a day helping people -- in his office and over the phone -- who needed assistance navigating the health exchange website, understanding the new health care law, or both.

"At first, we got a trickle of people seeking information," he said. "It's starting to become more of a flow."

More than two months have passed since the launch of online insurance markets including HealthCare.gov, and as the six-month open-enrollment period approaches its midway point, a growing number of people and organizations are serving as guides to navigating the complex task of shopping for and enrolling in plans.

"What's required is so much more complicated than purchasing something on Amazon.com," said Mr. North, whose group is one of a few dozen agencies listed on HealthCare.gov as a resource for people shopping for health care in the greater Pittsburgh area. "Amazon is not verifying your citizenship. Amazon is not verifying whether your small business is offering insurance."

In August, Health and Human Services Secretary Kathleen Sebelius announced that the government was awarding $67 million in grants to organizations to hire navigators, or people trained to assist Americans in shopping for and enrolling in plans. Mental Health America of Westmoreland County, for example, received $75,000 to hire a navigator and pay for her training, travel and equipment as she meets with people across Western Pennsylvania who need help signing up, said executive director Laurie Barnett Levine.

This week, Ms. Sebelius announced an additional $58 million in grants to 1,157 health centers that are helping uninsured or underinsured Americans to enroll, with $6.4 million going to 38 organizations in Pennsylvania.

One of the Pittsburgh organizations receiving funding is North Side Christian Health Center, which was given $78,162 this year and $37,194 for next year, according to the Health and Human Services' Health Resources and Services Administration.

Michael Parker, the health center's director of resource management, said the agency often serves people who are underinsured or uninsured, so helping people sign up for health care seemed like a good fit.

"As a federally qualified health center, we figured this would be a good way to make sure that our patients have the opportunity to become insured," he said. The health center now has eight people trained to be certified application counselors, as they are known in the new lingo of the health care landscape. Mr. Parker expects to send more of the center's employees through the certification training, which covers maneuvering through the website, privacy controls and defining common insurance vocabulary, such as co-pay and premium.

The counselors on Thursday morning had their first successful enrollment, he said.

"The gentleman left here very happy," Mr. Parker said. "He was actually hugging some of our nurses out the door."

The role of an application counselor is similar to a job in human resources, said David Bytnar, outreach and enrollment assistant at Sto-Rox Neighborhood Family Health Center, which also received funding from Health and Human Services. Mr. Bytnar, who began working as a counselor in early November, said his job entails everything from providing people access to a computer to helping them understand what information is needed in the application process.

Many people, when filling out forms ranging from a college application to paperwork to buy a car, feel trepidation and are glad for reassurance that they are completing their information correctly, Mr. Bytnar said. Applying for health care is no different, he said.

"That's why they hired people like me, to simply say, if I can't answer it for you, let's go ahead and talk to the marketplace together," Mr. Bytner said.

Navigating the health care system, for most of the people Mr. North has assisted as a volunteer, has been anything but simple, with technical problems with HealthCare.gov, as well as holes in the health care system in general. Each person he helps, he said, takes "hours of time."

Since Citizen Power was listed as a resource on HealthCare.gov in November, about 20 people have contacted Mr. North for assistance, many of them recently naturalized citizens.

Some have needed help understanding their options. But, he said, many have been "stymied" from even getting to the point where they can select an option due to website problems, especially the citizenship verification component, a problem not solved by calls to the Obamacare call center. Some of the people he has met with have needed to send in parts of their application by mail because they cannot complete the process online, he said.

On Thursday afternoon, he said in an email Friday, a person came to his office with a "relatively simple" case: a native-born American citizen who did not qualify for any subsidies. She was, he said, the first person he was able to help from the first step all the way through to enrollment.

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